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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMB INGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES SEA l! <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — w%ww everettwa.org <br />n oor it ATInNC ARE ACCFPTEn FROM R AM TO 4 PM 7 `11, <br />SITE ADDRESS: <br />PROPERTY TAX # <br />PERMI R <br />r <br />G EC' <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (allach copy of long legal description) <br />OWNER (,Ir — <br />Phone/Email 'S 2 $ <br />Address <br />City/State/Zip V -- <br />CONTRACTOR tl u', t <br />L & I Lic. # <br />'� /T1 <br />Address �`. �0If,✓/ Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building �t/��'R PAL C'Mr.T HEAT SOURCE: <br />Proposed Use of Building �7�yf„(�I C%{2T Gas Electric_ Other_ <br />Building type: _ Single Family _ Duplex __Townhouse _ Multi -Family X commercial <br />Type of project: _KNew _Addition _Remodel _ Repair_ T.I. _Sign _Sprinkler_ -Demolition_ Change of Use <br />Description of Work (additional space provided on the back): .,4 MEW 16/QDD 5f M(IN CIPAI— "'T ?0 <br />XIsT/!� <br />cnkt�;T-4)r-TeD 7o -Ma NX-n � wesT oFr THE c-ws771Vr-" CxnzPy77WAs� <br />CGYI�2T 6l1/LL BE U�Moll l�i� AND A cai;) lv1LL � p,UiU� I 2 <br />Have you started working without a permit? _YES _X_NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typeot Project: _New_Addo _Alteration _Repair <br />Typoof Project: _New_Addn _Alteration _Repair <br />Show Number (it) of fixtures <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced pair systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />_ <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backllow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other_ <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />I Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />� 1 LAW <br />Owner/Authoriz Agent Signature fete (Revised 22011) (2 <br />